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The Impact and Cost of Mental Illness: The Case of Bipolar Disorder

health careThe ramifications of bipolar disorder include a significant economic toll, as well as family disruption, caregiver stress, and an individual burden encompassing comorbid illnesses, substance abuse, poor functionality, and high suicide risk.

Economic toll is significant

Social and economic effects of bipolar disorder include functional impairment, disability or lost work productivity, and increased use of health services. Evidence for these impacts include cross-sectional studies, longitudinal studies, and true experiments (randomized trials of specific treatments or treatment programs).
Bipolar disorder is the most expensive mental health care diagnosis, both for patients with the illness and for their health insurance plans.
Bipolar disorder is the 6th leading cause of disability worldwide.
For every mental health care dollar spent on outpatient care for patients with bipolar disorder, $1.80 is spent on inpatient care. This suggests that better disease management could decrease the financial burden of bipolar disorder.
In a prevalence-based cost-of-illness study on bipolar disorder, total annual costs were estimated at $45.2 billion (1991 values).
In one study, the average lifetime cost per case ranged from $11,720 for persons with a single manic episode to $624,785 for persons with nonresponsive or chronic episodes.
In another study, direct costs totaling $7 billion consisted of expenditures for treatment-related inpatient and outpatient care, as well as non-treatment-related costs, such as the criminal justice system.
The $38 billion in indirect costs from the same study included the lost productivity of wage earners, totaling $17 billion; homemakers, $3 billion; and caregivers, $6 billion, as well as the cost of institutionalization, $3 billion, and the lost productivity costs for individuals lost to suicide, $8 billion.
Decreased functioning affects patients and families

Patients with bipolar disorder and their families experience significant losses in functional status and quality of life, placing untoward stress on personal relationships.
Loss of employment, difficulty in regaining employment, days lost from work, and the potential for increased interactions with the criminal justice system all contribute not only to the cost but also to the disability associated with bipolar disorder.
The degree of functional impairment may be even greater for patients with bipolar disorder with other chronic illnesses.
One study found that 56 percent of people with bipolar disorders abused or were dependent on illicit drugs, and 44 percent had comorbid alcohol abuse.
Caregiver burden decreases productivity

Providing close daily contact and care to patients with bipolar disorder exacts a toll on their families and caregivers.
Many patients with bipolar disorder divorce or experience martial problems.
Not only must caregivers of patients with bipolar disorder deal with the impact of patients’ symptoms, caregivers also feel the effects of patients’ illnesses on their work and leisure time.
The combination of missed work hours and lower productivity caused by stress adds a financial burden on the caregiver, as well as on society as a whole.

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